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Emerging gene and stem cell therapies for the treatment of erectile dysfunction

Nature Reviews Urology volume 7, pages 143–152 (2010)Cite this article

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Abstract

Erectile dysfunction is a prevalent condition that leads to significant morbidity and distress, not just for affected men but also for their partners. Very few currently available treatments ameliorate the underlying causes of the disorder and 'cure' the disease state. Much recent effort has been focused on the development of gene and cell-based approaches to rectify the molecular and tissue defects responsible for ED. Gene therapy has been investigated in animal models as a means to restore normal function to the penis; at this time, however, only one human trial has been published in the peer-reviewed literature. Recent gene therapy studies have focused on the modulation of enzymes associated with the NOS/cGMP pathway, and supplementation of trophic factors, peptides and potassium channels. Stem cell therapy has been a topic of interest in more recent years but there are currently very few published reports in animal models and none in human men. Although stem cell therapy offers the potential for restoration of functional tissues, legitimate concerns remain regarding the long-term fate of stem cells. The long-term safety of both gene and stem cell therapy must be thoroughly investigated before large-scale human studies can be considered.

Key Points

  • Gene and stem cell-based therapies for the treatment of erectile dysfunction offer the potential to rejuvenate tissues that have been damaged by a variety of physiological insults

  • A number of viral vectors for gene delivery are available, each with their own merits and drawbacks

  • Modulation of the NOS/cGMP pathway and supplementation of trophic factors have been the principle foci of gene therapy investigations, although a number of other treatment approaches have also been considered

  • Stem cell therapy offers the potential for restoration of functional tissues via differentiation of stem cells or possibly by release of trophic factors

  • Despite the potential therapeutic benefits, stem cell therapy is currently limited by ethical issues, risk of disease, and host morbidity

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  1. Department of Urology, University of California, San Francisco, 94143-0738, CA, USA

    Ahmed Harraz, Alan W. Shindel & Tom F. Lue

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T. F. Lue declares that he has acted as a consultant for Auxilium, Bayer, Eli Lilly, Medtronic and Pfizer, has received grant/research support from American Medical Systems and has been a board member for Genix Healthcare. A. W. Shindel declares that he has acted as a consultant for Boehringer Ingelheim and a section editor for Elsevier Yearbook of Urology. A. Harraz declares no competing interests.

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Harraz, A., Shindel, A. & Lue, T. Emerging gene and stem cell therapies for the treatment of erectile dysfunction. Nat Rev Urol 7, 143–152 (2010). https://doi.org/10.1038/nrurol.2010.8

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